My 87 year old mom is currently at the Psych ward in Fall River, RI. Her mental health has been deteriorating recently and we are looking into places that she might be comfortable at if and when she is no longer able to be at home in Wellfleet, Cape Cod with 24 hour care.

Her Dementia and paranoia seem to be the issues that keep home health care at bay, she can become violently uncontrollable at times, sometime after long lapses of nearly complete normal (for her) behavior. She is fiercely independent, living alone on a sand cul de sac on a marshy area of Wellfleet for the last 40 years.

Any thoughts, guidance and pointers on long term care places that cater to patients with dementia and psychiatric disorders, and where she could have a view of some sort, and maybe even where they would allow pets.

Tangential answer, based on experience with family members: You want a place that advertises "memory care" or the like — most of them use a euphemism for what is really the dementia ward.

I would urge you to try to make this move directly from the psych ward she is now on. Every move is going to cause additional confusion; try to just make one.

You mention "where she might be more comfortable if and when she is not longer able to be at home." Talk to her caregivers who have lots of experience with dementia patients and ask whether "if and when" has arrived. This is not something the patient herself can determine (and usually, dementia patients have a surprising capacity in the earlier stages to cover up symptoms), and family members at a distance will also have a hard time deciding. Usually it takes a crisis, and if she's in the psych ward now, it sounds to me like the crisis is at hand.

Once you get her into the right setting with the right care, and she adjusts, I think you'll find that she's much happier, despite her independent streak. We got my mother-in-law into a regular nursing home, at first, and she was bored and kept asking when she could go home. Then, wandering the halls (as dementia patients tend to do), she discovered the dementia unit on her own, and started spending her days there, because in contrast to the "regular" nursing home areas, in the dementia unit they had activities and entertainment all day long, and people she could have the same conversation with every day without getting strange looks. So we then moved her into that unit as soon as a spot became available.

Regarding pets — some places might allow it, but generally visits from dogs, cats and other critters are part of the program.posted by beagle at 9:26 AM on July 21, 2014 [1 favorite]

It's probably better to have family close by so you can get to her in case of emergencies. My boss had his now-deceased, mentally challenged brother moved from a facility in Florida to a facility near his home in Maryland for this reason; it was too much of a hassle for him to get someone to FL quickly if necessary.

Is there any family in the Cape Cod area? If not, the better option would probably be to move her close to you in LA or to your sister in NYC.

Fall River, MA (not RI) is reasonably close to Providence (RI), so you might also look in that area. Boston may also be do-able, and might have better-skilled caregivers.

This likely goes without saying, but make sure that someone in your family actually visits any facility you are considering.posted by tckma at 9:26 AM on July 21, 2014

Also, any info on "Care Home" places or what it even means??posted by silsurf at 12:26 PM on July 21, 2014

I have visited 4 memory facilities in Los Angeles in the last year in choosing one for my in-laws. Please memail me and I would be happy to share all the details.

Honestly, if you want to go out for coffee and chat, I'd be more than happy to clue you into all the ins and outs of finding an appropriate facility.posted by Sophie1 at 1:54 PM on July 21, 2014

From a quick, limited perusal of a few sites, "care homes" are nice but they are not basically small assisted living facilities. There might be some out there that are specifically designed for dementia care, but dementia care is not the same as assisted living, at all. The assisted living client is assumed to be generally competent and able to take care of themselves with a few exceptions, like dressing or bathing, and they get help with that. Plus generally there's meals and housekeeping. A dementia patient doesn't know when it's mealtime, needs help with more than just a few things, can't reliably be left on their own for any length of time.posted by beagle at 2:00 PM on July 21, 2014

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